Is minimally invasive prostate surgery safe?

Minimally invasive prostate surgery is relatively safe and more reasonable than other resection surgeries. However, this type of surgery requires a comprehensive physical examination before the operation, mainly to reduce the risks of the operation. In particular, patients with anemia should wait until the test results are normal before undergoing surgery to prevent accidents during the operation.

The following are some common methods of prostatectomy:

(1) suprapubic transvesical prostatectomy;

(2) Retropubic prostatectomy;

(3) transperineal prostatectomy;

(4) Transurethral resection of the prostate.

The above surgical methods have their own advantages, disadvantages and indications, and should be selected according to the patient's condition and the doctor's mastery of surgery. In foreign countries, transurethral transurethral resection of the prostate accounts for more than 90% of all prostate surgeries, but in my country, most hospitals still use open surgery.

Among open surgeries, suprapubic transvesical prostatectomy is the most commonly used procedure and is a basic surgical method that urologists must master. This procedure is relatively simple and easy to master, and rarely causes urinary incontinence after the operation. This surgical method is more appropriate for patients with other lesions in the bladder. However, this operation requires bladder incision, and if the prostate capsule is tightly adhered to the gland, the capsule may occasionally be torn, which will cause certain difficulties in hemostasis.

Retropubic prostatectomy does not require bladder incision. The prostate is removed under direct vision, and suprapubic cystostomy is not required. Recovery is fast after surgery. However, the surgery is more complicated, with more bleeding. Improper treatment may cause infection, urinary incontinence, etc.

The advantages of transperineal prostatectomy are small surgical scope, small damage, small impact on the whole body, and fast recovery after surgery. However, the anatomy of the perineum is complicated, the surgical field is poorly exposed, and it is easy to cause postoperative sexual dysfunction.

Transurethral resection of the prostate (TURP) causes less damage, less pain, quick recovery, and a wide range of surgical adaptations. This surgery requires certain equipment and high technical requirements for the surgeon. Currently, TURP has the best effect and is still the "gold standard" for BPH treatment.

Patients who have been clearly diagnosed with prostate cancer before surgery are not suitable for resection via suprapubic transvesical surgery, whether conservative or radical. Patients with severe cardiovascular disease, obstructive pulmonary disease, severe diabetes, significant liver and kidney dysfunction, and systemic hemorrhagic diseases should not undergo open suprapubic transvesical prostatectomy before their condition is well treated or if they are estimated to be unable to tolerate open surgery despite active medical treatment.